Hospitals, health systems can always do more to preserve and protect our environment
Hospitals represent a cornerstone of every community they serve, delivering healthcare to hundreds of thousands of residents nationally and providing jobs to a significant portion of their local populace.
Yet these essential community organizations represent one of the heaviest users of energy and a top generator of waste, potentially creating significant concerns around their carbon footprint at the same time they do so much good.
Many industries contribute to this problem—and do their part to mitigate their impact on the environment. Hospitals, however, bear an outsized responsibility for one simple reason: It is their business, and their mission, to protect and help improve the lives of those they serve—including protecting and sustaining our precious ecosystem.
Of course, measures to address the local environment should be part of a strategic plan of every hospital as the industry confronts a multitude of threats, including changing weather patterns, poor air quality and rising temperatures.
It’s not only good for the environment—it’s also a benefit to the bottom line. One authoritative study, published in 2012 by the Commonwealth Fund, found that hospitals nationwide could save more than $15 billion over a decade through programs to cut energy use, boost supply efficiencies and reduce typical hospital waste such as expired drugs and radioactive items, medication boxes and excess food.
Climate change is disrupting many necessities to good health—from clean air and water to access to food and shelter. The World Health Organization estimates that between 2030 and 2050, climate change will cause about 250,000 additional deaths per year from malnutrition, malaria, diarrhea and heat stress.
Some other statistics that should make us take notice:
• Healthcare facilities account for more than 8% of the nation’s annual energy consumption, and generate nearly 8% of the country’s carbon dioxide according to the U.S. Energy Department. • Hospitals generate an average of about 42 pounds of total waste per patient day—everything from hazardous radioactive items to packaging of a wide array of supplies.
Catholic Health Initiatives, based in Englewood, Colo., is a sponsoring member of Healthier Hospitals, a group of 15 health systems that came together six years ago to transform the healthcare sector and underscore the importance of being responsible stewards of the environment. The Healthier Hospitals Initiative continues as a free, voluntary program sponsored by Practice Greenhealth, serving as both a road map and a call to action for hospitals to adopt environmental best practices.
Since its inception, the national program has provided more than 1,300 hospitals—large and small, urban and rural—with free tools and resources on how to conserve energy, recycle, use fewer chemicals and adopt other eco-friendly measures.
Like so many hospitals and health systems, environmentally focused efforts at CHI have been widespread, ranging from simple operational changes to technological advances designed to reduce energy consumption. Though our system is diverse and each facility has varying capabilities, every facility and every employee in our system is doing something to help.
Despite these efforts, we know there is still much more to be done in a multiyear effort on scientifically sound, successful efforts toward sustainability. Fossil fuel use, waste and an array of industrial processes continue to accelerate climate change at an alarming rate. The health of the planet—and the health of the people we serve—is at significant risk.
To contribute to the solution, the healthcare sector needs to be ever mindful of the chemicals it uses and discards, recognizing that extreme weather events can send those chemicals into our water, air and food sources. Whenever possible, let’s recycle materials that can be repurposed, and buy natural products—or those that are gentler on the environment. And we need to work harder and do more to conserve energy and water and become smarter consumers.
A huge part of delivering healthcare to our communities is preserving a healthy environment.
Pushing risk onto providers isn’t the solution to rising costs
Regarding the June 25/July 2 Guest Expert “Value in healthcare remains an imperative; it’s just the matter of how we get there” (p. 27), despite pockets of over-utilization, overall the U.S. has low utilization compared with other countries with much more costeffective (i.e., better value) healthcare systems. We are chasing a model that assumes over-utilization is the problem and tries to rein it in by pushing risk onto providers.
We are failing to address huge gaps in access to appropriate care, due to the lack of providers in rural and poverty areas, financial barriers from high patient cost-sharing, excessively narrow networks, etc. The resulting under-utilization drives preventable complications, emergency room visits and hospital utilization, boosting costs.
Shifting risk onto providers does not help. It adds administrative cost (already far higher than in any other country) and encourages “cherrypicking” patients and populations to make meeting quality metrics easier, and thus avoiding poorer, sicker, rural and underserved populations, where meeting metrics will be more challenging. Wealthier urban populations get more and increasingly expensive care, while those who need care the most are losing access.
The real problems are disparities in access to care and excessive administrative costs, and “valuebased payment” models are making these worse. The total cost of care nationwide continues to rise far in excess of the general inflation rate.
Dr. Stephen Kemble Assistant clinical professor of medicine John A. Burns School of Medicine University of Hawaii at Honolulu
There’s little incentive for brokers to push ACA exchange plans
Regarding the article “Agents and brokers flee ACA exchanges despite Trump administration support” (ModernHealthcare.com, July 3), there is no incentive at all in some states to assist. The insurance companies do not compensate agents at all. Some agents are charging a fee, but to do so legally it must be done contractually and that is often more work than it’s worth. It’s really sad what’s happening in this country with healthcare, and the U.S. is falling behind the rest of the world in caring for its people.
Lynn Shurtleff Owner, agent Secure Retirement Solutions Bristol, Tenn.
Single-payer system would level the playing field
I have spent 30 years in healthcare administration, working for two of the largest for-profit hospital chains and multiple large not-for-profit systems, as well as government. In contrast to most of my colleagues, I fully support expanding Medicare to cover all ages. And if that should happen, hospitals would certainly benefit.
In Canada and other democracies with single-payer health plans, private-sector providers continue to play a critical role, as it should be. For hospitals, they would operate on a more level playing field. With everyone insured there is less need for tax exemptions and other accommodations for uncompensated care. All hospitals would be taxed at the same rate and would compete solely based on quality, service, cost and access. Isn’t that a goal that both providers and patients should desire to achieve?
The Affordable Care Act has resulted in tens of millions of people being covered. Despite the Washington rhetoric, it is clearly better than what we had before. But tens of millions of Americans are still uncovered. And there is little hope for cost containment with the ACA, which was built on an inefficient, private insurance system. Marketing and overhead costs for Medicare are a fraction of those expenses in the private sector.
You can be a capitalist, as I am, and still acknowledge the exceptional cases where government’s role should be expanded. Health insurance is one such exception, as virtually every democracy has realized. Medicare for all in the U.S. is inevitable.